辽宁省住院医师规范化培训结业考核实践技能考试满意度调查

Investigation of satisfaction on practical skills in graduation examination of resident training in Liaoning Province

目的了解住院医师规范化培训结业考核实践技能考试实施情况,以发现问题,提高培训质量。方法选择辽宁省2010、2013、2017年结业考核的4 484名临床医学专业考生进行调研,收回有效问卷4 412份,总调查有效率98.39%。调查内容包括标准化病人(standardized patient,SP)考试、小站考试、计算机模拟病例(computer simulated case,CCS)考试及临床技能操作考站4部分共20个项目。将调查原始数据输入Excel数据库,利用Excel 2017及SPSS 10.0进行数据处理和分析。结果实践技能考核各部分内容设计较合理;考生对考试设计满意度较高,且呈逐年上升趋势,2017年达73.93%;SP考试中角色扮演(包括神态的逼真度和体征症状的模拟真实性)部分考核重点有待加强(2010年仅有14.84%的学员非常同意);考生认为CCS考试难度有逐年增高趋势;超过三分之二的考生评价临床技能操作考站设置合理,难度适中。结论进一步深化探索SP考核模式;加强医学人文类等内容的考核;进一步完善住院医师临床思维培养;以考核为导向,规范临床培训。

Objective To get well-informed of the practical skills examination of residents’ standardized training in order to detect problems and improve the quality of training. Methods A total of 4 484 clinical medical examinees from 2010, 2013 and 2017 in Liaoning province were investigated by questionnaire, from which 4 412 valid questionnaires were collected and the total survey efficiency was 98.39%. The survey included the standardized patient (SP) examination, the small station test, the computer simulated case (CCS) examination and the clinical skill operation test station with parts 20 projects. Excel was used to sort and record the data. SPSS 10.0 software was used for statistical analysis. Results All parts of the practical skill assessment was reasonable. The examinees’ satisfaction with the test is showing an upward trend year by year, up to 73.93% in 2017. In the standardized patients examination, the key points of the role play (including the fidelity and simulated authenticity of the physical signs) need be strengthened (14.84% in 2010). Examinees thought the difficulty of computer simulation case examination is increasing year by year. More than 2/3 examinees evaluated the clinical skill operation test station set was reasonable and the difficulty was moderately. Conclusions We should further deepen the exploration of standardized patients assessment model;strengthen the medical humanities in training;improve the residents’ clinical thinking;take examination as the guidance and standardize clinical training.